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The “best place” debate centers on which disciplinary setting is best for degree programs in nonprofit management education. We contribute to the discussion by reflecting on the constraints and opportunities intentionally identified in a developing program within an established business school. We ground our work in the nonprofit sector’s interdependence with the market and public sectors, and identify opportunities for reciprocity within a business school setting. Finally, we identify cultivating interdisciplinary relationships as a strategy to ameliorate tension between a competitive vs. collaborative “forced choice” approach. Subscribe to JNEL

Purpose This study sought to evaluate whether associations between adolescent combustible cigarette smoking and e-cigarette progression were explained by beliefs that e-cigarettes substitute for cigarettes in nonsmoking situations. Methods Adolescents (N = 1,799) from public high schools outside of Philadelphia, PA, completed in-classroom surveys at wave 1 (fall 2016, beginning of ninth grade) and at 6-month intervals for the following 36 months (fall 2019, beginning of 12th grade). Results A parallel process latent growth curve model revealed that the pathway from baseline smoking to e-cigarette use trend through baseline e-cigarette substitution beliefs was significant (B = .02, z = 2.16, p = .03), indicating that the positive effect of greater baseline cigarette smoking on the rate of e-cigarette progression was channeled through e-cigarette substitution beliefs. The indirect effect from baseline smoking to e-cigarette use trend via e-cigarette substitution beliefs trend was also significant, albeit negative (B = -.05, z = -2.61, p = .009). The negative indirect effect suggested that the strong positive effect of baseline cigarette smoking on baseline substitution beliefs was followed by a slowing of the overall rate of change from baseline. Given that the total effect from baseline smoking to e-cigarette trend was not significant (p = .91), the results suggested complete mediation. Conclusions Among adolescents with greater use of combustible cigarettes, beliefs regarding the substitutability of e-cigarettes in nonsmoking situations appear to foster progression in e-cigarette use. Addressing these beliefs in the school setting and through media campaign messaging early in adolescence may help to prevent the use of e-cigarettes and combustible cigarettes.

Purpose: This research note evaluated the collaboration, recruitment, enrollment processes, as well as outcomes of an online, self-managed parent training program (Success With Stories [SWS]) concurrent with a Head Start school curriculum. Method: This case examination presents the research processes used to examine an online program concurrent with Head Start school programming. Challenges, outcomes, and next steps in the process were evaluated. The engagement of parents who completed the program was examined. Results: Collaborative processes were developed, and recruitment strategies were initiated. Of the 92 parents who expressed immediate interest, 38 registered and 16 consented but only seven completed the program. Of the parents who completed the program, survey data revealed high levels of parent satisfaction, motivation, and perceived competence. Conclusions: Results indicate a breakdown in the recruitment, enrollment, and completion processes. Results indicate that SWS has promised to address target areas with the intended audience. However, online interventions are only useful if they are accessed and completed. Future directions to increase program completion are discussed.

Introduction In the coronavirus disease 2019 era, debate around the risk of contagion in school is intense in Italy. The Department of Welfare and Health of Florence promoted a screening campaign with rapid antigen tests for all students and school personnel. The aim of this study was to assess the circulation of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) in the school setting by means of mass screening in every primary and middle school in Florence. Methods All students and school personnel at primary and middle schools in Florence were asked to take part. The campaign started on 16 November 2020 and was completed on 12 February 2021. If a subject had a positive result on rapid antigen testing, a molecular test was performed to confirm the result. Results In total, 18,414 subjects were tested: 15,233 students (82.7%) and 3181 school personnel (17.3%). The rapid antigen test gave a positive result in 27 cases (0.15%). Of these, only 14 tests were confirmed to be positive on molecular testing. These results show a very low number of cases of SARS-CoV-2 among the study subjects (0.08%). Conclusions These results show that the spread of SARS-CoV-2 in the school setting was low in Florence during the screening period.

Background In 2014, the Danish Government introduced a wide-ranging school reform that applied to all public schools in Denmark. A distinctive feature of the reform was that it became mandatory to implement an average of 45 min of daily physical activity within the curriculum. Using the RE-AIM framework as an evaluation tool, the objective of the current study was to evaluate the reach, effectiveness, adoption, implementation, and maintenance of mandatory physical activity within the curriculum at ten Danish schools. Methods A complementary mixed-methods approach using accelerometers, questionnaires, and semi-structured interviews was conducted. A total of 10 schools were invited to participate, including 846 students, 76 teachers, and 10 school managers on various levels. Students were invited to wear an accelerometer for seven consecutive days. Teachers were invited to participate in a questionnaire, and school managers were encouraged to take part in a semi-structured interview. Results Results showed that, on average, 45.2% of the students were active at least 45 min daily within the curriculum. Teacher and school management interest in physical activity, competencies development, and shared decision-making were identified as central factors for adoption of the requirement. Scheduling physical activity within scheduels and collaborations with external parties were found to influence implementation. Finally, internal coordination, motivated school staff, and school management priority were identified as central factors for maintenance. Conclusions This study provides an evaluation on a nationwide physical activity requirement in Danish public schools. When introducing a wide-ranging nation-wide requirement on physical activity within the curriculum, school managers need to prioritize and support the implementation process. Teachers need to be involved in the decision processes in order to ensure motivation and local ownership. The study also highlights the benefits of an internal coordinator as well as development of a shared strategy among schools, municipalities, and other stakeholders in order to succeed with the implementation.

OBJECTIVES This cluster-randomized controlled community trial aimed to assess the efficacy and costs of fluoride varnish (FV) application for caries prevention in a high-risk population in South Africa. METHODS 513 children aged 4-8 years from two schools in a township in South Africa were randomly allocated by class to the FV or Control (CO) groups. In addition to supervised toothbrushing with fluoridated toothpaste in both groups, FV was applied in 3-month intervals by trained local non-professional assistants. Intraoral examinations were conducted at baseline, 12, 21 and 24 months. Primary outcome was the increment of teeth with cavitated lesions (i.e. newly developed or progressed, formerly non-cavitated lesions), requiring restoration or extraction over the study period. Additionally, treatment and re-treatment costs were analyzed. RESULTS 513 children (d1-4 mft 5.9 ± 4.3 (mean ± SD)) were randomly allocated to FV (n = 287) or CO (n = 226). 10.2% FV and CO teeth received or required a restoration; 3.9% FV and 4.1% CO teeth were extracted, without significant differences between groups. While FV generated high initial costs, follow-up costs were comparable in both groups, resulting in FV being significantly more expensive than CO (1667 ± 1055 ZAR vs. 950 ± 943 ZAR, p

Do-it-yourself (DIY) artificial pancreas systems (APSs) are gaining popularity among children with type 1 diabetes. Little is known about how school systems provide care for children who use DIY APSs, and available guidance for schools is limited. This study explored school staff perspectives on DIY APSs through a national survey of school nurses about their current practices, beliefs, and attitudes toward DIY APSs. Although one-quarter (23%) of school nurses reported experience with DIY APSs in school, nearly half (46%) had no prior knowledge of this new technology. The majority (82%) reported that children should be allowed to use DIY APSs in school, although there was less consensus about school nurse responsibilities with these devices. Qualitative responses added context regarding potential barriers, including the need for more informed guidelines and training and fears of liability. Future development of school guidelines for DIY APSs is necessary and should incorporate stakeholder perspectives.

The purpose of this study was to explore the phenomena of participation in a democratic large ensemble experience in a secondary public school setting. Specific research questions included (a) Do high school band students feel capable of performing a music work without teacher intervention? (b) In what ways do high school band students describe the experience of performing in a student-led large ensemble? (c) What music decisions were most often made by high school band students in a student-led large ensemble? and (d) Were there any changes in high school students’ perceptions of autonomy following a student-led large ensemble music rehearsal and performance experience? Findings illustrated that the democratic experience increased student autonomy and music discrimination across larger distances in the classroom as students listened to other nonsimilar sections. Furthermore, student voice, self-efficacy, and personal affect also increased as a result of the experience. Students felt empowered to offer their rehearsal critiques; however, a lingering concern is that participants continued to feel that their peers would not listen to their opinions on rehearsal issues or strategy usage.

Background: School-based telehealth (SBTH) plays a valuable role in child asthma management, although nurses have concerns with caregiver engagement. Mobile technology (m-health) has potential to improve this engagement. Objective: We identified barriers and key desired features of an asthma m-health application as a supplement to an existing SBTH asthma program in rural settings. Methods: Multimethod design using school nurse surveys and interviews with school and SBTH personnel to describe processes related to implementation of an m-health application. Results: Nurses reported SBTH programs were an ideal setting to identify potential families for m-health. Benefits of caregiver education and engagement and barriers related to technology, smart phone data availability, and family buy-in were described. Desired application features included education on inhaler technique, asthma symptom, and medication adherence reports. Conclusions: The feedback identified from nurses can be incorporated into an asthma m-health program within an SBTH program to facilitate implementation.

Physical education teachers with a strong sense of purpose are more resilient and maintain high-level performance over time. Therefore, this longitudinal, mixed-methods exploratory case study describes how two teachers’ (Gary and Wayne) sense of purpose in life and well-being has influenced their intent to remain teaching in high-poverty schools. This inquiry followed the two participants over four consecutive school years (2015–2019) and included eight formal interviews with Gary and Wayne, two administrations of the Ryff’s Psychological Well-Being Scale questionnaire, and one administration of the Teaching Sustainability Questionnaire over the four-year project. Gary’s and Wayne’s strong purpose in life contained central values that led to their intention to remain teaching in their high-poverty school context. This strong sense of purpose stemmed from their perceived internalized and externalized support associated with life experiences, familial influence, and the school environments where they worked. Gary’s and Wayne’s sense of purpose appeared to have a direct effect on their intention to remain teaching in the high-poverty schools where they were employed. Identifying a teacher’s sense of purpose and the extent to which it aligns with a specific school district’s mission/vision may be an important factor in recruiting and retaining teachers in high-poverty environments.

The importance of translated children's books to the literary and cultural development of children is well documented, and the study of other countries is an important part of the school curriculum across grade levels. Therefore, purposes of the research were (1) to share results of research on outstanding translated children's books published from 1990-2000; (2) to provide a bibliography of these books that can be used by librarians, teachers, and students in a study of other countries; and (3) to present an application of a collaborative study on the use of translated books by a middle school librarian with teachers in a real-life setting. An appendix contains a 72-item recommended list of translated children's books. (Contains 11 references and 4 tables.) (Author/RS) Reproductions supplied by EDRS are the best that can be made from the original document. r-Minor changes have been made to Cr) V21 improve reproduction quality. Using Outstanding Translated Children's Books in the School Setting to Promote an Understanding of Other Countries and Cultures Maureen White, Ph.D. University of Houston-Clear Lake Nancy Bluemel, Ph.D. Grapevine-Colleyville Independent School District U.S. DEPARTMENT OF EDUCATION Office of Educational Research and Improvement EDUCATIONAL RESOURCES INFORMATION CENTER (ERIC) This document has been reproduced as received from the person or organization originating it. N Points of view or opinions stated in this document do not necessarily represent C/) official OERI position or policy. () BEST COPY AVAILABLE PERMISSION TO REPRODUCE AND DISSEMINATE THIS MATERIAL HAS BEEN GRANTED BY

Objectives The aim of this study was to identify perceptions of safety and effectiveness of a provincial type 1 diabetes school care plan, and to best inform future improvements in school care to accommodate the shifting needs of families, best clinical practices and new medical technologies. Methods A cross-sectional satisfaction and feedback questionnaire to inform quality improvement was offered to both families of children with type 1 diabetes who receive care at school through a Delegated Diabetes Care Plan and to their program coordinators during the 2017‒2018 school year. Results The response rate was 29.8% (160 of 537) for families and 68.2% (45 of 66) for coordinators. The majority of parents and coordinators reported that the care plan is meeting both safety and diabetes management needs. On a 7-point Likert scale, the safety score, expressed as mean (standard deviation), was 6.0 (1.2) by families and 5.7 (1.3) by coordinators, with higher scores reflecting greater satisfaction. Diabetes management was rated 5.6 (1.2) out of 7 by families, and 5.4 (0.8) out of 7 by coordinators. Families and coordinators expressed the need for individualization of care, and suggested modifications to how information is presented. There was near-unanimous support for future integration of continuous glucose-monitoring devices into the school setting. Conclusions British Columbia’s provision of diabetes care in the school setting is overall perceived to be safe and is generally well received by families and coordinators. In this study, we provide valuable information to improve the care of children with type 1 diabetes in schools, including support for further individualization of care and future integration of diabetes technology into the school setting.

Students with intellectual and developmental disabilities (IDD) are incredibly vulnerable to poor post-school outcomes. Two mandates, the Higher Education Opportunity Act and Workforce Innovation and Opportunity Act, have emerged that may provide avenues to counter the discrepancy between the desire for career and college paths and actualization of employment and enrollment. The authors explore these legislative acts, their impact on transition services for students with IDD, and how school personnel can collaborate to create family, school, and community partnerships. Based on these acts, a practice framework, and the unique transition needs of students with IDD, practice recommendations are provided. Specific strategies for promoting application of these laws in the school setting are offered. Special attention is given to the partnership between special educators and school psychologists to help them navigate the legal implications for students with IDD and their families.

Schools serve as the ideal location for implementing interventions to increase physical activity (PA) as children spend most of their day in the school setting. As adolescents become more and more sedentary and obesity statistics become more dire, efforts to increase physical literacy and PA should be heightened. Physical literacy is the ability for a child to understand the movement of their body and how it can be manipulated to increase activity for recreation or sports movement. When physical literacy is paired with school-based multi-component programs, children are more likely to make a behavior change. As educators know, children are more likely to make a behavior change when mastery of content is achieved, and the lesson is tailored to their needs. Even small changes, like moving a little more or adding an additional serving of vegetables to the diet, can make a profound impact. In the current review we discuss: 1) the state of PA within school systems; 2) provide a rationale for why school systems fail to meet said guidelines; and 3) suggest how guidelines can eventually be achieved through the promotion of physical literacy and effective school-based multi component programs.

Objective First, we will update recommendations for the prehospital management and care of patients with exertional heat stroke (EHS) in the secondary school setting. Second, we provide action items to aid clinicians in developing best-practice documents and policies for EHS. Third, we supply practical strategies clinicians can use to implement best practice for EHS in the secondary school setting. Data Sources An interdisciplinary working group of scientists, physicians, and athletic trainers evaluated the current literature regarding the prehospital care of EHS patients in secondary schools and developed this narrative review. When published research was nonexistent, expert opinion and experience guided the development of recommendations for implementing life-saving strategies. The group evaluated and further refined the action-oriented recommendations using the Delphi method. Conclusions Exertional heat stroke continues to be a leading cause of sudden death in young athletes and the physically active. This may be partly due to the numerous barriers and misconceptions about the best practice for diagnosing and treating patients with EHS. Exertional heat stroke is survivable if it is recognized early and appropriate measures are taken before patients are transported to hospitals for advanced medical care. Specifically, best practice for EHS evaluation and treatment includes early recognition of athletes with potential EHS, a rectal temperature measurement to confirm EHS, and cold-water immersion before transport to a hospital. With planning, communication, and persistence, clinicians can adopt these best-practice recommendations to aid in the recognition and treatment of patients with EHS in the secondary school setting.

This study examines the role of six popular social networking sites (SNSs)—Instagram, Snapchat, Facebook, Twitter, YouTube, and Pinterest—in a high school setting. Students, teachers, and administr...

Background Mathematical modeling studies have suggested that pre-emptive school closures alone have little overall impact on SARS-CoV-2 transmission, but reopening schools in the background of community contact reduction presents a unique scenario that has not been fully assessed. Methods We adapted a previously published model using contact information from Shanghai to model school reopening under various conditions. We investigated different strategies by combining the contact patterns observed between different age groups during both baseline and “lockdown” periods. We also tested the robustness of our strategy to the assumption of lower susceptibility to infection in children under age 15 years. Results We find that reopening schools for all children would maintain a post-intervention R0 0 of approximately 3.3 provided that daily contacts among children 10–19 years are reduced to 33% of baseline. This finding was robust to various estimates of susceptibility to infection in children relative to adults (up to 50%) and to estimates of various levels of concomitant reopening in the rest of the community (up to 40%). However, full school reopening without any degree of contact reduction in the school setting returned R0 virtually back to baseline, highlighting the importance of mitigation measures. Conclusions These results, based on contact structure data from Shanghai, suggest that schools can reopen with proper precautions during conditions of extreme contact reduction and during conditions of reasonable levels of reopening in the rest of the community.

Food allergy is a growing health and safety concern that affects up to 8% of school-age children. Because children spend a significant part of their day in school, and the overall number of school-age children with food allergy has been increasing, management of food allergies relies on the collaboration of allergists, families, and schools to treat and prevent acute allergic reactions. For schools, this involves policies centered on food allergen avoidance, preparedness with epinephrine autoinjectors, adequate school personnel training, and accommodations for an equal opportunity learning environment. Partnerships with allergists, primary care providers, students, families, school nurses, and school staff are vital for creating individualized and effective care plans that will allow all children, including those with food allergies, a safe and nurturing learning environment.

The advantages of continuous glucose monitoring (CGM) and insulin pump systems have increased the popularity of these devices among students in the school setting. The use of diabetes technology at school and school-sponsored activities strengthens the student’s consistent use of the technology and increases the overall beneficial effects. The school nurse has many considerations when supporting the student with diabetes technology. Integrating this technology into diabetes care at school can be complex with collaboration and safety considerations fundamental to success. This is the third article in a three-part series on the use of technology in managing diabetes in youth. The first article described CGM devices and provided tips for the school nurse in incorporating CGM into the student’s individualized healthcare plan. The second article summarized insulin pump technologies, from conventional insulin pump therapy to advance automated insulin delivery systems and described keys to success with insulin pump technologies. The purpose of this article is to address some special considerations for facilitating the use of diabetes technology in the school setting. Topics to be discussed are tips on including insulin pump therapy in the student’s individualized healthcare plan, safe use of diabetes technology during physical activity, and implications for school nursing practice.

PURPOSE This study was done to compare the survival rates of cast gold and ceramic onlays placed in a dental school setting. MATERIAL AND METHODS An electronic search was conducted in the patient records at Adams School of Dentistry, University of North Carolina at Chapel Hill for onlay codes that were in the database (From 1998 until 2018). Progress notes and radiographs were scrutinized to establish the survival time of the restorations. Any complications that occurred during the life time of the restorations were noted. The survival was summarized by categorization based on ranges of survival time in years; group 1: 1 to 5 years, group 2: 6 to 22 years. The mean survival time and standard deviation were calculated. One-way ANOVA was used to determine whether there was a statistically significant difference in the survival times between gold and ceramic onlays. RESULTS The mean survival rate of cast gold onlays (86.6%) was comparable to that of ceramic onlays (81.1%). The gold onlays in Group 1 had a higher mean survival time (2.43 years) than the ceramic onlays (2.03 years). This difference was statistically significant (p = 0.002). The ceramic onlays in Group 2 had a mean survival time of 19.75 years while gold onlays had a mean survival time of 17.63 years. This difference was not statistically significant (p = 0.91). CONCLUSION It was concluded that while the survival rate of ceramic onlays (81.1%) was inferior to that of cast gold onlays (86.6%), it was comparable.

As the primary healthcare professionals in the school setting, school nurses field questions about diet and exercise. Nurses’ familiarity with nutrition and dietary patterns can help them respond to student concerns. Plant-based diets, those which promote eating mostly fruits and vegetables with smaller portions of animal foods, have recently gained popularity in the United States. Most plant foods are rich in fiber, antioxidants, and complex carbohydrates, as well as vitamins and minerals that support good health and maintenance of a healthy weight. Most children and adolescents can meet their nutrient needs on a plant-based diet, but should be careful to include a wide variety of foods in the diet in order to achieve nutrient adequacy.

This article explores how a disability justice framework would provide greater access to law school and therefore the legal profession for disabled students of color; specifically, disabled Black, Indigenous, and Latinx students. Using DisCrit principles formulated by Subini Annamma, David Connor, and Beth Ferri (2013), this article provides suggestions for incorporating a disability justice lens to legal education. In doing so, this article specifically recognizes the work of three disability justice activist-attorney-scholars, Lydia X.Z. Brown, Talila “TL” Lewis, and Katherine Pérez, and considers lessons from their advocacy and leadership that can apply in the law school setting.

Addressing the consumption of animals as an educative and environmentally crucial question, this paper empirically examines the meaning of meat and animal consumption for learners in school setting...

Given the hierarchical nature and structure of field schools, enrolled students are particularly susceptible to harassment and assault. In 2018, the National Academies of Sciences, Engineering, and Medicine (NASEM) released recommendations to help prevent sexual harassment and assault of women in academia. Although these recommendations are specific to higher education and exclusive to women, some can be modified and applied to the context of archaeological field schools. We review the NASEM's recommendations, with particular attention to those applicable to the field school setting, and provide suggestions for making field schools safer and more inclusive learning environments for all students. Although we present recommendations for practices that can be implemented at field schools, additional research is needed to understand how sexual harassment occurs at field schools and how the implementation of these recommendations can make learning safer.

Peer-led education programming is a frequently used strategy for implementing adolescent sexual and reproductive health education. Research on effectiveness has demonstrated mixed outcomes for adolescent participants but consistently indicates benefits for peer health educators. Studies evaluating the impact on peer health educators typically rely on self-reports or feedback from one perspective. This study contributes to the literature by drawing on the perspectives of multiple stakeholder groups to understand the impact of the project on peer educators. Utilizing focus groups and interviews, this study focuses on data collected regarding the perceived effects of a peer-led project on peer educators in a public school setting. Themes reflect positive effects that include growth for peer health educators at school, home, and within the community. Qualitative analyses depicted that the program enhanced peer educators’ knowledge and professional development, increased communication between parents and participants, and inspired the peer educators to be agents of change in their communities outside of project implementation. Implications for future programming and research are addressed.

Statement of problem The clinical survival of different types of post-and-core systems requires assessment. Purpose The purpose of this retrospective clinical study was to evaluate the clinical survival rate (CSR) of custom-fabricated cast metal and prefabricated (both metal- and fiber-reinforced composite resin post) post-and-cores as a function of patient- and restoration-related variables. Material and methods A retrospective analysis was conducted on electronic charts indicating that these patients had received some type of post-and-core between January 2003 and January 2018. A total of 754 records were included in the analysis based on the inclusion criteria. Data were analyzed by using the Kaplan-Meier and Cox proportional hazards analysis. Results Kaplan-Meier analysis demonstrated the mean survival time for each group to be 12.0 years for fiber-reinforced composite resin posts, 11.8 years for cast metal post-and-cores, and 10.2 years for prefabricated metal posts. Although the mean survival time differed by 1.8 years among groups, with prefabricated metal posts having a slightly higher risk of failure, this effect was not statistically significant (P=.067). The effect of post type also failed to reach significance when controlling for patient demographics and post position in a Cox proportional hazards analysis (P=.106). However, the Cox model did show that survival was associated with tooth position (P=.003), cement (P=.021), and type of restoration (P Conclusions Analysis showed no evidence that post-and-core survival was significantly associated with 3 types of post-and-cores (custom-fabricated metal, prefabricated metal, and prefabricated fiber-reinforced composite resin). The percentage of root in the bone, tooth position, cement, and type of restoration, however, were significantly associated with survival.

This article serves as a Position Statement of the Pediatric Pharmacy Association (PPA), which supports safe and effective medication use in schools. PPA recommends that schools develop comprehensive medication use policies to support safe and appropriate administration of both chronic and emergency medication in schools. These policies must address issues specific to pediatric patients, including off-label and over-the-counter medication use, various pediatric dosage forms, as well as appropriate medication storage, administration, and disposal practices. PPA also advocates for continued staff development and education regarding laws, regulations, and policies surrounding medication use in school to ensure safe and effective care of children and adolescents in the school setting.

The hospitality industry has been thriving in Taiwan; as a consequence, educational institutions and training programs in the future development of the culinary industry have become extremely impor...

In this research we explore the pedagogical affordances associated with the use of a 3D printer in a middle school classroom (11–12 years old). We introduced the 3D printer in a classroom where no one, including the teacher, had prior knowledge of 3D printing. Lessons using the 3D printer were designed to correspond with the mathematics curriculum and benefit students’ mathematics learning. The use of 3D printing as a technological tool for learning mathematics, in particular, led to numerous failures. Failure was not designed for in the lesson plans, but rather was a product of a malfunctioning new technology and the inexperience of the classroom teacher and students. These failures were deemed to be “productive” because of the way in which they inspired more learning and perseverance, rather than the way in which the task was initially conceptualized. Our study utilizes qualitative and quantitative methods as evidence. Implications for classroom instruction and further research will be discussed.

Aim Regular physical activity and low levels of sedentary time have positive health effects on youth, and data are needed to base public health recommendations on. Here, findings of device-based physical activity and sedentary time in sixth graders are presented. Data below are presented as mean (SD). Subject and methods Three hundred and eight sixth-grade girls [11.6 (0.6) years] from the CReActivity study in Germany wore accelerometers (ActiGraph GT3X) for 7 consecutive days. Moderate to vigorous physical activity (MVPA), light physical activity (LPA), and sedentary time (ST) was obtained during school days with a focus on recess times. Results Girls spent 79.9 (23.2) minutes in MVPA and 9.4 (1.2) hours in ST during schooldays, of which 20.5 (8.2) minutes and 3.8 (0.4) hours respectively were accumulated during school hours. On average, students had 35.4 (4.5) minutes break, of which 6.3 (3.2) minutes (17.8%) were spent in MVPA activity and 16.5 (6.2) minutes (46.6%) in ST. Conclusion School setting is an important factor for physical activity and sedentary time. Therefore policy, curriculums, and school environment should promote physical activity und reduce sedentary time during school hours.

Background Young women and adolescent girls experience many challenges in their lives related to sanitation, hygiene, and menstruation. These challenges are often seen in a school setting and are more intense in peri-urban areas, where the infrastructure in educational institutions is often outpaced by the population, generating poor sanitary conditions. This can lead to adolescent girls contracting reproductive tract infections, such as candidiasis, as a result of poor menstrual hygiene. This study assessed menstrual hygiene management among students at a senior high school in the Volta Region, Ghana, in order to identify improvements to be made by school authorities to improve the health and comfort of students during menstruation. Methods This cross-sectional, descriptive study was conducted among 265 students aged 13–22 years, who had attained menarche. A pretested, structured questionnaire was used to collect data on their menstruation knowledge and practices, and the available sanitary facilities for menstrual hygiene management in the school. This was followed by an evaluation of the available facilities using a survey process. The Pearson chi-squared test was used to test the association between a student's year group and their knowledge and practices. Results The majority of the girls had accurate knowledge on menstruation (52.8% reported the correct length of a woman's menses, 74.7% correctly reported that a woman's menses comes once a month). However, the majority (63%) of participants reported the belief that menstrual blood is unhygienic and this belief was significantly associated with year group (PConclusions There is a need for Ghanaian educational institutions to provide proper sanitary facilities and for parents to provide sanitary pads or towels, which will allow girls who are menstruating to be comfortable and free of reproductive health infections. To achieve this, school authorities should be educated on the importance of providing the necessary sanitary facilities and parents should be educated on the necessity of provision of sanitary pads.

This study on Menstrual Hygiene Management (MHM) was carried out in two secondary schools in the Bamako district, “Chaine Grise” and “Cheick Modibo Diarra” located respectively on the right bank and the left bank depending on the geographic position of the Niger river. This work took place over a period of 6 months from January 2019 to June 2019. The objective of this study was to study menstrual hygiene management in school setting for girls aged 16 to 18 in two secondary schools in Bamako. It was a transversal and qualitative description. The study population consists of girls aged 16 to 18 years enrolled in one of the selected secondary schools. At the end of this study, we arrived at the following results: *50% of the girls in our study have poor knowledge about menstruation; *10% of girls miss school at least one day a month during menstruation; *90% of girls use hygienic cotton to absorb menstrual blood; *90% of the sources of supply for hygienic products are mothers. The unsanitary conditions of the toilets, lack of light and the non-separation of the toilets according to gender guidelines were found in 99% of the cases: *99% of girls say that the poor state of health infrastructures was one of the causes of genital infections linked to poor management of menstrual hygiene; *lack of water in the toilets (99%). Through these results, we conclude that, in our context, menstruation remains a taboo and shameful subject for girls. In addition, some of their menstrual hygiene practices are a real danger to their health.

Introduction: In Hungary vaccination against Hepatitis B is mandatory in 7th grade (age 12-13) and is given by the school doctor. In this pilot study, following the best practices for patient-centered communication, a program was organized when the school doctor met the classes prior to immunization for an interactive conversation. The aim of the program was to minimize the possible fears of the students about vaccination, to seek their assent to immunization, to get the adolescents involved in disease prevention, and to expand the protective effect of immunization by means of health education. Indirect aims were to facilitate responsible health behaviour and to improve vaccine adherence in the future. In association with the immunization against Hepatitis B, the program was focused on protecting the liver and health gen-erally. With the active participation of the students and a natural flow of questions several issues of health protection were reached. Method: To evaluate the success of the program described in the article, a question-naire was used. Results: Participation on the evaluation 8, 20 and 32 months after the program was 85%, 65% and 30% respectively, showing that it has reached the attention of the adolescents. On the question how the program influenced their attitude towards immunization, 63% of the answers indicated positive effect, 33% negated any change in attitude and 4 % had remaining questions or was still stressed about the immunization. Conclusion: At the mandatory vaccination of 7th graders against hepatitis B by the school doctor, the school setting provides efficient circumstances for interactive communication; vaccination against hepatitis B provides a unique starting point for health education. The pilot study has demonstrated that the program was able to raise the adolescents’ interest in topics of health protection with a lasting memory and that it could facilitate their assent to immunization. However, it has also proved that adolescents can be often stressed - and do have questions - about immunization and emphasises the need for programs to alleviate their stress and to answer their ques-tions. It might be an important factor to prevent vaccine hesitancy and improve vac-cine adherence in the future. Bevezetes: Magyarorszagon a Hepatitis B elleni vedőoltast iskolai kotelező kampanyoltas kereteben 7. osztalyos tanuloknak (12-13 eves kor) adjak az iskolaorvosok. Ebben a probakutatasban a paciens-kozpontu kommunikacio legjobb gyakorlatat kovetve olyan programot szerveztunk, melyen az iskolaorvos az oltas előtt egy interaktiv beszelgetesre talalkozott az osztallyal. A program celjai voltak, hogy minimalizalja a tanulok lehetseges felelmet az oltassal kapcsolatban, hogy megnyerje az ő tudatos bele-egyezesuket az oltashoz, hogy bevonja a fiatalokat a betegsegmegelőzesbe, es hogy kiterjessze az immunizacio vedő hatasat az egeszsegneveles modszere altal. Indirekt celok voltak, hogy elősegitse a felelős egeszseg-magatartast es javitsa a jovőbeni oltas-elfogadast. A Hepatitis B oltashoz kotődően a program fokusza a maj es altalaban az egeszseg vedelme volt. A diakok aktiv reszvetelevel es a kerdesek osszefuggő lancolataval a program az egeszsegvedelem szamos teruletet erintette. Modszer: A cikkben leirt program eredmenyessegenek vizsgalatara kerdőives felmerest hasznaltam. Eredmenyek: A kerdőives felmeresben valo reszvetel 8, 20 es 32 honappal a program utan 85%, 65% illetve 30% volt, ami azt mutatja, hogy sikerult felkelteni a diakok figyelmet. Arra a kerdesre, hogy hogyan befolyasolta a program az oltashoz valo hozzaallasukat, a valaszok 63%-ban pozitiv hatast mutattak, 33% tagadta, hogy valtozott volna a hozzaallasa, 4%-nak tovabbi kerdesei maradtak, vagy igy is stressznek eltek meg az oltast. Kovetkeztetesek: A 7. osztalyosok Hepatitis B elleni kampanyoltasa soran az iskola hatekony kornyezetet teremt az iskolaorvossal valo interaktiv kommunikaciora; a Hepatitis B elleni vedőoltas egyedulallo kiindulopontot nyujt az egeszsegneveleshez. A probakutatas bebizonyitotta, hogy a program felkeltette a diakok erdeklődeset az egeszsegmegőrzes temajaval kapcsolatban maradando emleket hagyva, es elősegitette a vedőoltashoz valo tudatos beleegyezesuket. Azt is igazolta azonban, hogy a serdulők sokszor stresszkent elik meg a vedőoltast es kerdeseik vannak ezzel kapcsolatban. Nyomatekositja tovabba olyan programok szuksegesseget, amelyek ezt a stresszt csokkentik, es a felmerulő kerdeseket megvalaszoljak. Utobbi fontos tenyező lehet a jovőbeni oltasellenesseg megelőzeseben es az oltasi hajlandosag javitasaban.

There are a significant number of students on maintenance medications for chronic diseases or with diagnoses that may result in medical emergencies requiring administration of medications in school. With passing of legislation in all 50 states allowing self-administration of emergency medications for allergic reactions and asthma, the landscape of medication use in schools is changing. These changes have raised questions about the need for legislation or policy development relating to self-carrying and self-administration of medications for other disease states, undesignated stock of emergency medications, and administration of medications by non-medical personnel. Medication administration in the school setting has become a complex issue, and this review will discuss current legislation related to medication use in schools and provide best practices for administering medications to children and adolescents while at school.

Educational institutions implement school information system (IS) solutions for efficient academic processes and improve the student experience, and thus tend to upgrade to new school IS, ceasing the use of old school IS. Extant studies of information system discontinuance are in organizational in general. This study is solely a school organization setting, specifically a thorough understanding of contributing factors that facilitate the intention of school information system (IS) discontinuance. Organizational level IS discontinuance intention OLIDI model was used as a lens and anchored by grounded theory. Semi-Structured interviews were used to collect data from school administrators and users of information system (IS) of Surigao State College of Technology. A qualitative statistics approach and coding of words are used to analyze the intention of IS discontinuance and provide model for school setting IS discontinuance. The findings show that system shortcomings, organizational initiative, environmental change, system investment, and institutional pressures were the critical determinants of increased intentions to replace the existing school information system (IS). The study findings are useful to school administrators to identify long term flexibility required for policies to overcome the capability of shortcomings that emerge over the system life span and underline risk associated with continued use of unsupported systems.

The objective of this systematic review was to identify the association between overweight/obesity and level of physical activity in Brazilian children and adolescents in the school setting. For search strategy, the main reference databases (PubMed, LILACS, SciELO, SPORTDiscus, Web of Science, ERIC) were used. Baseline searches resulted in 3,265 potentially relevant titles (2,775 titles after removal of duplicate studies); 21 studies met all inclusion criteria and were included for analysis. Studies were carried out from 2007 to 2019; 47.6% of them were conducted in Southern Brazil, and only one study had nationwide approach. Prevalence from 5.4% to 21% was identified for overweight, 3.5% to 16.9% for obesity and 11.8% to 40.1% for overweight + obesity. According to results, 64.3% of overweight, 69.8% of obese and 37.7% of young overweight people were considered insufficiently active. The non-standardization of instruments to assess levels of physical activity and the lack of information regarding other Brazilian regions were classified as important limitations. The results reinforce the increase in the prevalence of overweight in Brazilian children and adolescents, and the high prevalence of physical inactivity among them. For every ten overweight children/adolescents, six are reported to be insufficiently active. O objetivo desta revisão sistemática foi identificar a associação entre excesso de peso, obesidade e nível de atividade física em crianças e adolescentes brasileiros, no ambiente escolar. A busca eletrônica foi realizada nas principais bases de dados de referência (PubMed, LILACS, SciELO, SPORTDiscus, Web of Science, ERIC). A pesquisas nas bases resultaram em 3265 títulos potencialmente relevantes (2775 títulos após análise duplicada); 21 estudos preencheram todos os critérios de inclusão e foram analisados. Os estudos foram realizados entre 2007 e 2019, 47,6 % deles foram realizados no sul do Brasil, e apenas uma pesquisa foi realizada a nível nacional. Foi identificado prevalências de 5,4% a 21% para sobrepeso, 3,5% a 16,9% para obesidade e 11,8% a 40,1% para excesso de peso (obesidade + sobrepeso). De acordo com os resultados, 64,3% dos jovens com sobrepeso, 69,8% dos obesos e 37,7% daqueles com excesso de peso foram considerados insuficientemente ativos. A não padronização dos instrumentos para avaliar os níveis de atividade física e a pouca representatividade de outras regiões brasileiras foram classificadas como lacunas importantes. Os resultados reforçam o aumento da prevalência de excesso de peso em crianças e adolescentes no Brasil, e a alta prevalência de inatividade física entre estes jovens. A cada dez jovens acima do peso, seis são insuficientemente ativos.

AIM Whilst prevalence of paediatric feeding disorders is high amongst children in specialist schools, there is little guidance for professionals supporting families with a child feeding orally with established risk of aspiration. We sought perceptions of the complex feeding decision-making process amongst health professionals supporting families in the specialist school setting in New Zealand. METHODS An observational, cross-sectional, national online survey of speech-language therapists was followed by in-depth interviews with seven health professionals associated with one specialist school. RESULTS Survey responses from 32 speech-language therapists showed inconsistency in assessment processes and how family, children and school staff are involved in feeding decisions, with 71% reporting a doctor had been involved. Respondents were not confident in their ability to predict aspiration risk, with 41% reporting that they could often determine risk, 41% sometimes and 16% never. Sixty-three percent of respondents indicated that level of risk was written in a report for a child and 50% reported that every child at high risk had a management plan. Speech-language therapists valued professional supervision, but it was not always available. Health professionals were broadly positive about the collaborative nature of decision-making in most but not all situations. They described communication, access/institutional and emotional barriers to timely, shared decision-making. CONCLUSION These findings demonstrate variability in how families are supported to make complex feeding decisions. Health professionals identified a need for clearer processes and strengthened communication between family, school and health professionals. Trusting relationships are critical if all families are to be well-supported.

Violence in schools is a global issue. Approximately 32% of Mexican students have experienced some form of violence in the school setting in their lives. Previous research has tended to focus on the causes of violence and antisocial behaviors in offenders or adolescent samples and has found evidence to suggest the underlying role of environmental and personal factors. The present study investigates the effect of positive school environment and agreeableness as protective factors against antisocial behaviors in a sample of undergraduate and graduate students (n = 304) from northwestern Mexico. Our results demonstrate that a positive school environment has a negative effect on antisocial behaviors via mood and anxiety disorders as well as in interaction with agreeableness, suggesting an interplay between personality and environment. These findings can provide some basis for the development of university programs aimed at fostering positive environments that promote student mental health and protect against antisocial behaviors.

Introduction Every year, 1/10,000 children experiences a food‐anaphylactic reaction. Most of these events, including attack‐related deaths, may happen during the school hours. In the current study, we assessed the influence of information and communication technologies (ICT) in the school‐staff's education on food allergy and anaphylaxis (FAA). Methods The target population of this intervention was non‐university teaching centers from the local Regional Education Council, including both state and private institutions. The digital intervention was supported by the free‐of‐charge and open‐source learning‐management Aulatic Educational Platform. Structured questionnaires were developed to evaluate the educators' knowledge, feelings, and self‐efficacy on FAA, in addition to a satisfaction and quality survey of the training program. Results A total of 1748 school‐educators were virtually enrolled from May 2016 to June 2020 in one of the 8‐week course editions, with 80.6% of attendees successfully completing the full training. All scores concerning school‐staff's basic knowledge and self‐efficacy on FAA significantly improved after the educational intervention, reaching a high level of satisfaction among participants (98.5%) over the 4‐year educational program. Conclusion Our results highlighted the effectiveness of a focused e‐learning activity to improve teachers and school caretakers in the management of food allergic scholars and anaphylactic reactions during the school hours. The use of ICTs tools should become an integrated part of curricular frameworks in non‐university education, leading to a better care of FAA school children.

Background:High-quality data in Electronic Dental Records (EDR) is essential for dental schools to provide high-quality patient care, improve dental students’ professionalism, and support a platform for research. Therefore, ensuring data quality in EDRs is extremely important.Objective:To perform a quality appraisal of EDRs by evaluating their accuracy and completeness.Methods:This was a Cross-sectional Observational Study conducted over four consecutive years in a dental school setting. Manual chart reviews were performed on an annual basis. EDR data were audited for accuracy and completeness. Accuracy was evaluated by comparing the entered data with an external source, where possible. An EDR data field was considered complete if it was not missing.Results:A total of 1,720 de-identified chart reviews were studied. The accuracy of the data to identify the patient was 93%. The completeness of the essential components of EDRs was 48-94%. Completeness was highest for documenting the patient’s chief complaint (94%) and the lowest for recall plan (48%). Completeness of data documenting social and behavioral determinants of health in EDRs was 36-77%, with the highest proportion of completeness in this domain being for oral hygiene habits, smoking habits, and social history.Conclusion:The quality appraisal of EDRs varied according to the data field. Understanding patterns of accuracy and completeness in EDRs will guide training and quality enforcement activities.

Beverley Bostock-Cox explains what school nurses can do to ensure the safety of pupils with asthma

Atopic dermatitis, a form of eczema, has a physical, psychological, and social impact on students at school. The purpose of this article is to provide current information surrounding the symptoms and treatment of this disorder. School nurses can be a partner in atopic dermatitis care and improve health outcomes for these students.

Background Technological innovations allow for collection of 24-h recalls (24HRs) in a broader range of studies than previously possible. The web-based Automated Self-Administered 24-Hour Dietary Assessment Tool (ASA24) has been shown to be feasible and to perform well in capturing true intake among adults. However, data to inform use with children are limited. Objective This observational feeding study was conducted to evaluate children's ability to accurately report a lunchtime meal using ASA24 without assistance. Methods The study was conducted among children (n = 100) aged 10-13 y within a school setting. Students were served an individual cheese pizza, baby carrots, ranch dip, yogurt, a cookie, and 1 choice of water, juice, or milk. Plate waste was collected and weighed. The next day, participants completed ASA24 and a sociodemographic questionnaire. Descriptive statistics were generated to determine match rates by food item and age, and linear regression analyses were conducted to examine associations between sociodemographic characteristics and accuracy of reported energy and nutrient intake. Associations between true and reported energy and nutrient intakes and portion sizes were assessed with use of t tests. Results Just under half (49%) of children fully completed ASA24 (median time, 41 min). Children reported an exact, close, or far match for 58% of all foods and beverages consumed, ranging from 29% for dip to 76% for pizza, but also reported some items not consumed as part of the study meal. Older children completed the recall in a shorter time than younger children (mean 31 among 13 y compared with 52 min among 10 y). Intakes of energy (39%), protein (33%), and sodium (78%) were significantly overestimated, whereas portion sizes for cookies (53%) and juice (69%) were underestimated. Conclusions Children can report some foods and drinks consumed using ASA24, but our findings suggest challenges with independent completion, necessitating research to examine strategies, such as training and resources, to support data quality.

International audience; Aim : General practitioners (GPs) are ideally placed to identify suicidality in adolescents. However, adolescents are often reluctant to confide in their GPs about these problems, and GPs are not comfortable when questioning them about suicide. We previously proposed the BITS test, a set of four opening and four additional questions, to alert doctors about possible suicidality in an adolescent. We validated its use in the identification of suicidality (“frequent suicidal ideation or suicide attempts at one time or another)” in 15‐year‐old adolescents in a school setting. The objective of the present study was to assess the detection utility of this method in 13‐to‐18‐year‐olds in primary care.Methods : We carried out a screening utility study in general practices in 17 French‐speaking sites in four countries and three continents. Each GP was instructed to use the bullying, insomnia, tobacco, stress (BITS) test with five to ten 13‐to‐18‐year‐old adolescents, consulting consecutively, for any reason. They subsequently asked them questions about their suicidality.Results : One hundred and two GPs tested a total of 693 adolescents; 13.0% of the adolescents (girls 15.4%, boys 9.9%) reported suicidality (1.6% known, 11.4% previously unknown). A score of at least 3 on the BITS scale was associated with suicidality (sensitivity: 65.9, specificity: 82.5%).Conclusions : The BITS test is a pragmatic instrument, alerting the GP to an adolescent's previously unknown suicidability, whatever the reason for consultation.

Background Urban minority children experience high levels of asthma morbidity. Poor school performance can be an indicator that asthma is in poor control. Little attention has been paid to examining real-time links between asthma and academic performance, particularly in high-risk groups. Objective Examine 1) academic performance across a range of indicators in a group of urban children with asthma and urban children without chronic illness and ethnic differences in these associations, and 2) associations between asthma and academic performance in the group of urban children with asthma and ethnic differences in these associations. Methods Two hundred sixteen black/African American (33%), Latino (46%), and non-Latino white (21%) urban children, ages 7 to 9 years completed a clinic- and home-based protocol that assessed asthma and allergy status, objective measurements of lung function, and academic functioning. Results Analyses revealed that children with asthma experienced a higher number of school absences when compared with healthy controls. Greater disparities in academic outcomes emerged when examining ethnic differences within the groups of children with and without asthma. Poor academic outcomes were observed in Latino children with asthma. Furthermore, a strong correspondence of poor asthma outcomes and decrements in academic performance were seen in the full sample, and these associations emerged across ethnic groups. Conclusion Asthma activity contributes to poorer academic outcomes across a range of indicators, and urban minority children with asthma, particularly Latino children, may be at heightened risk for poorer academic performance. School management guidelines for asthma need to be consistently implemented and tailored for school staff, caregivers, and students with asthma to address challenges of managing asthma within the urban school setting.

Emotional response toward menarche is a psychological problem for female adolescents. In addition menarche is considered taboo and embarrassing by female adolescents. Many female adolescents have a negative feeling and do not prepare for menarche. The purpose of this paper is to identify female adolescents' preparation and emotional response toward menarche. This study used a qualitative method including focus group discussion (FGD) and in-depth interview. FGD was carried out with five female adolescents in a school setting about female adolescents' preparations and emotional response toward menarche. The participants were female adolescent students who had not entered menarche yet. Some teachers were also interviewed as key persons. The results of this study indicate that female adolesents do not prepare for menarche. The participants did not have adequate knowledge and felt ashamed and worried about menarche. This study recommended the use of reproductive health education related to menarcheal preparations in school and community settings to prepare female adolescents to confidently face menarche.

The Specialized Health Needs Interagency Collaboration (SHNIC) program at the Kennedy Krieger Institute is a community-based program that provides on-site training and technical assistance to safely manage the integration of children with special health needs into educational and community settings. SHNIC frequently receives seizure education requests throughout the school year, specifically regarding vagus nerve stimulation. Vagus nerve stimulation involves an implanted medical device used to deliver electrical pulses to the vagus nerve for additional seizure management. The school nurse needs to understand the purpose and function of the hidden medical device, including the parameters for use of the device and magnet, safety considerations, and side effects. SHNIC has developed educational materials specific to vagus nerve stimulation to aid the school nurse in providing staff training, developing care plans, and creating a safe school experience for students with special health needs.

Coaching in the school setting typically follows the traditional format of preconference, observe, and postconference, where feedback on teaching performance is shared but often delayed. Professional development (PD) provides teachers with skills to enhance their teaching practice with little to no follow-up or support. The most effective way to produce change in the school setting is to show the connection between PD and student performance, and iCoaching can help to bridge the gap. In this study, four teachers participated in a focused PD session and subsequent iCoaching sessions where the researcher used iPods and Bluetooth earbuds as a bug-in-ear (BIE) device. A coach served as a live, remote observer providing coaching prompts to increase teacher-delivered opportunities to respond (OTR). The results indicated that iCoaching was effective in increasing teacher-delivered OTR and in increasing student responses and academic performance.

OBJECTIVES In January 2014 implementation of the Medicaid expansion of the Affordable Care Act (EACA) in Oregon increased the number of children and adults qualifying for the Oregon Health Plan (OHP). Simultaneously, dental care benefits for adult Medicaid members were restored in Oregon after a period of noncoverage. This study evaluated the impact of these changes on the receipt of endodontic services in the Graduate Endodontic Clinic (GEC) at Oregon Health & Science University. METHODS A retrospective electronic health records (EHRs) database review was conducted from July 2010 through June 2017, a seven-year period covering 3.5 years before (pre-EACA) and 3.5 years after (post-EACA) implementation of EACA. The number of completed anterior, premolar and molar non-surgical root canal therapies (NS-RCT) was retrieved from de-identified EHRs by targeting dental codes. Pre- and post-EACA frequencies were compared and analyzed by patient age [

PurposeThe purpose of this paper is to demonstrate the power of experimental design as a technique to understand and evaluate the most important factors which influence teaching effectiveness for a postgraduate course in a higher education (HE) context.Design/methodology/approachThe methodology involves the execution of a case study in the form of an experiment in a business school setting. The experiment was carried out with the assistance of over 100 postgraduate students from 26 countries. The data were collected over a two year period (2015 and 2016) from a postgraduate course offered by the same tutor for repeatability reasons.FindingsThe key findings of the experiment have clearly indicated that students’ perceptions of teaching effectiveness based on intuition and guesswork are not identical to the outcomes from a simple designed experiment. Moreover, the results of the experiment provided a greater stimulus for the wider applications of the technique to other processes across the case study HE sector.Research limitations/implicationsOne of the limitations of the study is that the experiment was conducted for a popular postgraduate course. It would be beneficial to understand the results of the experiment for less popular postgraduate courses in the university in order to drive improvements. Moreover, this research was conducted only for postgraduate courses and the results may vary for undergraduate courses. This would be an interesting study to understand the differences in the factors between undergraduate and postgraduate teaching effectiveness.Practical implicationsThe outcome of this experiment would help everyone who is involved in teaching to understand the factors and their influences to improve students’ satisfaction scores during the delivery of teaching.Originality/valueThis paper shows how experimental design as a pure manufacturing technique can be extended to a HE setting.